September 3, 2008

Fight Club: Reflections on Mexico City

This year, no earth shattering news emerged from the conference. There were no newsflashes on the treatment, vaccine, microbicide or prevention fronts. In fact, some of the biggest news had to do with the rate of new HIV incidence in the United States as reported by the U.S. Centers for Disease Control and Prevention. The rate is 40 percent higher than previously estimated.

But even the fact that the AIDS epidemic in the United States has been underestimated failed to provoke shock and awe. That is partially because the numbers did not indicate that we had a massive spike in new infection rates, but rather that we’ve developed better methodology that allows us to report more accurately the number of new people becoming HIV positive (56,300 rather than 40,000 in 2006, for example). Still, the figures clearly show that we are not in control of AIDS in America and that we need to redouble our efforts to do better than allowing more than 55,000 new infections a year of a disease that is truly preventable.

It was interesting to see how many different AIDS organizations and AIDS service organizations (ASOs) used the revised overall CDC number, as well as numbers more specific to subgroups (53 percent of all new infections among MSM! 45 percent of all new infections among African Americans! 34 percent of all new infections among people younger than 30!) as justification for their individual missions. We need housing! We need better prevention! We need more awareness among gay men/women/African Americans/teenagers/Latinos! We need condoms in jails!

The fact is we need all these things—at once. As soon as the embargo on the CDC numbers was broken, the press releases went flying as everyone pitched for their piece of the federal funding pie.

In America, AIDS groups often have to lobby for their constituents in a way that is directly competitive with other AIDS organizations (this is not as common in other countries where there are often fewer AIDS groups and more money); there isn’t enough money to fulfill everyone’s agenda at once. Inadequate funding of key AIDS programs in the United States causes this infighting within the AIDS community (e.g., witness how northern and southern states wrestle to secure Ryan White CARE Act funding when both areas have adequate need for funding). Sometimes I wonder whether this is intentional. When I was in college in Hartford, Connecticut, the cops spared themselves the effort of going head-to-head with the many gangs that threatened the city’s safety; instead, they left them to duke it out with each other. It was a strange position I thought—leaving the gangs to cull each other. And it has occurred to me more than once that perhaps the best way to weaken the collective force of the AIDS community is to pit its many factions against one another.

While I recognize that inadequate levels of funding leads ASOs to fight for their own needs, I think more AIDS organizations should pool their outcries and yell until Capitol Hill listens to their communal complaint and figures out a way to address all the issues critical to fighting AIDS in America—together. Because they are all interrelated. If we can get housing, for example, for people newly released from prison, or better access to care to people who test positive and have no health insurance, we will be more successful at stopping the spread of the disease. But if we have to choose, for example, to help only the uninsured newly diagnosed while ignoring HIIV-positive people re-entering society after being incarcerated, we’re not going to shut down the spread of AIDS as effectively—or quickly. And time is a wasting.

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Previous Comments:

Vic R, San Jose CA, 2008-09-05 16:43:18
Why in the world won't any onhe stand up and say the numbers were so off in the states? Every dollar spent by ASO's come about based on numbers of infected living in a given area. Our president continued the lies about new infections to simply cut the funding available in thes country. Has any one seen a push to provide funding based on the "corrected" numbers? Face it, we'd rather through funds at corupt goverments outside our countries then face the prolem here at home. Sad, Vary Sad...

Dony Jauregui, Phoenix, 2008-09-05 11:25:52
I am studying to be a Journalist at a community college. Am too HIV positive and wanting to spread to know very much in this lifetime. I am 20 years old and people more than half of my age don't know much about this virus/disease and what it's doing everyday. I agree with this article. I'd like to see more said. Education is one of the keys here to stopping HIV.